Table 1

A summary of the main themes regarding the positive aspects of training in a tertiary setting

ThemeSubthemesExample quotes from interviewees
Enable trainees to learn more about the tertiary centresManaging complex patients, including those who have reached their ceiling of care‘It is about producing doctors who can deliver healthcare and if you want a good doctor who knows what they are talking about in a DGH you need to expose them to tertiary care otherwise their ceiling of knowledge will be capped and they will flood the tertiary system with referrals’. (Participant 1 (P1))
Better understanding of district general–tertiary hospital dynamics
Increased confidence in making referrals to tertiary hospitals in the future
Tertiary hospitals offer many learning opportunitiesManaging complex or sick patients‘You gain lots of useful skills like practical applicable skills and what happens on the other side of a retrieval’. (P2)
Attending courses, for example, at related university or academic institutions
Can often be the ‘general paediatrician’ for the team
Presenting in large meetings, for example, multidisciplinary or cross-site meetings
Unique opportunityFeels like a special place to be/will not see the same elsewhere‘There are so many specialities here on the ward and things you won’t see anywhere else in the UK. It can be overwhelming’. (P3)
‘It is a unique and funny place to work. It is so subspecialised with extreme and unique pathology. I think it important to experience’. (P1)
Interesting patients
Opportunity for career explorationProject opportunities and curriculum vitae building‘I am actually doing a project with the neurosurgeons and we are going to present at an international conference, they persistently ask you if you want to get involved’. (P4)
Deciding if you want to do a subspecialty job‘I wasn’t considering this speciality until I came here. I have managed to do so much for example, national conference, become an APLS instructor, audits’. (P2)
Building on specialty interest‘People are always scouting for someone who is going to be the next professor and to join their subspecialty’. (P5)
Other strengthsGood team atmosphere‘It’s great having the other specialities around to discuss with or when there is overlap or diagnostic uncertainty’. (P6)
Working with other specialties